Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 4351047535 | MI |
NPI | 1013584093 |
---|---|
Provider Name | Davin Gong |
First Address | Ann Arbor, MI 48109-5328 |
Second Address | Ann Arbor, MI 48109-5328 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2021 |
Last Update Date | 08/06/2021 |